A Cost Saving Quality Improvement Project in Solid Organ Transplant Population Following Tacrolimus Switch from Prograf® to Adoport® Immunosuppression – A Single Centre Experience
Manchester Royal Infirmary, Manchester, United Kingdom
Meeting: 2019 American Transplant Congress
Abstract number: D9
Keywords: Ethics, Immunosuppression
Session Information
Session Name: Poster Session D: Quality Assurance Process Improvement & Regulatory Issues
Session Type: Poster Session
Date: Tuesday, June 4, 2019
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall C & D
*Purpose: Tacrolimus is widely used immunosuppressive drugs in transplantation. The use of generic medications is cost saving and economically advantageous for the National Health Services (U.K). We describe our experience of implementing a switch from branded Prograf®(BTac) to generic Adoport®(GTac) in a large cohort of transplant recipients.
*Methods: To select the eligible cohort, strict inclusion and exclusion criteria were devised based on current health, creatinine, eGFRs, and Tacrolimus levels. Patients were approached by the clinical care team and an agreed medication switch over date followed by repeat blood 10-14 days later was set. Data was collected on demography, refusals, delayed & reverse switches, side effects, intolerance, rejections, renal biochemistry & tacrolimus levels pre/post switch.
*Results: The cohort of 524 patients (m=309, f=215) was identified on BTac at our transplant unit. n=43 (8.2%) were deemed not suitable and 19 (3%) refused to switch from BTac to GTac. Mean Tacrolimus levels changed by >20% in n=147 (34%) patients. A dose adjustment post switch was needed in n = 74(17%) patients and n=13 had to switch back to Prograf® from Adoport® due to side effects. Until now n= 424 patients (80 %) have been switched to GTac. There were two graft losses and 4 (1%) death reported in the 12-month switch over period related to other factors.
*Conclusions: This is a quality improvement project carried out for the first time on a large scale in the United Kingdom which reported successful transition to the generic Tacrolimus preparation i.e Adoport and has also demonstrated a safe alternative to the branded Prograf. The majority of patients tolerated the switch over well with a relatively small number of side effects and overall no statistical difference in their renal function soon after switchover. This project enabled the extra saving of £540,000 per annum without impacting on clinical quality. The comparable outcome of both branded and generic version is currently underway.
To cite this abstract in AMA style:
Mulreid L, Vincent M, Laycock L, Summers A, Bhutani S. A Cost Saving Quality Improvement Project in Solid Organ Transplant Population Following Tacrolimus Switch from Prograf® to Adoport® Immunosuppression – A Single Centre Experience [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/a-cost-saving-quality-improvement-project-in-solid-organ-transplant-population-following-tacrolimus-switch-from-prograf-to-adoport-immunosuppression-a-single-centre-experience/. Accessed May 8, 2025.« Back to 2019 American Transplant Congress